woodslamp
Table of Contents
Wood's lamp - UV light for dermatologic assessment
see also:
Introduction
- the Wood's lamp emits long wave UV light (typically in the 320–400 nm range, with a peak wavelength around 365 nm and traditionally use Wood’s glass - barium silicate with nickel oxide that blocks most visible light while transmitting UVA, but new devices usually just use 365nm LEDs) which is used to detect flourescence of skin or hair to help diagnose various conditions
- 365 nm wavelength is energetic enough to excite many endogenous and exogenous fluorophores in skin, hair, nails, and some materials, causing them to fluoresce in visible light, yet it remains in the safer UVA range
- it has various use cases:
- differentiating epidermal vs dermal hyperpigmentation:
- melanin acts as an absolute light absorber.
- if a dark patch (like melasma) becomes significantly more prominent with sharp borders under the lamp, the pigment is superficial (epidermal).
- if the patch remains unchanged, the pigment is settled deeper in the skin (dermal)
- differentiating true vitiligo vs fading rash:
- hypopigmented skin caused by scarring or poor blood flow stays dull.
- true autoimmune vitiligo, which completely lacks pigment, glows with a stark, blinding chalk-white or blue-white outline
- also useful for detecting ash-leaf vitiligo of tuberous sclerosis
- differentiating acne vs Pityrosporum folliculitis:
- red bumps on the chest or back can look identical to regular acne.
- normal acne blocks follicles and shows minor red/orange speckles, whereas a fungal yeast overgrowth (Malassezia) will glow in broad yellow-green sheets
- detecting tinea fungal infections
- BUT cannot rule out a tinea infection on its own
- common body ringworm and athlete's foot (typically caused by Trichophyton rubrum) generally show no fluorescence
- Trichophyton tonsurans lives inside the hair shaft (endothrix) and does not fluoresce at all
- assessing Rx success of tinea and detect potential areas for relapse
- antifungal treatments destroy the fungi, the brightness of the fluorescence steadily diminishes
- detecting Pseudomonas in wounds
- detecting porphyrins in urine
- detecting presence of dried cat urine
- cat urine is generally highly concentrated and contains high concentrations of phosphorus and blood plasma proteins (such as albumin)
- bright yellow or neon yellow-green fluorescence but over a long period, as the components break down, the glow slowly fades into a duller, pale white or faint yellow
- BUT false positives due to:
- carpet cleaners, wallpaper glue, laundry detergents (usually blinding, bright ice-blue or stark white rather than yellow), and spilled tonic water can also glow
- thus need to check shape and smell to confirm
- detecting scorpions at night (they are nocturnal):
- scorpions fluoresce a vibrant, bright neon green, cyan, or blue-green colour
- although you may need a higher wattage UV lamp for this
- a Wood's lamp should NOT be used for corneal flourescein staining eye examinations as:
- 365nm is the wrong spectrum for fluorescein - you need cobalt-blue light (~450–490 nm) viewed through a yellow filter
- 365nm thus gives much lower sensitivity for detecting corneal pathology (only ~50%)1)
- 365nm gives unnecessary UV-A radiation to the sensitive eye - indeed in normal use of a Wood's lamp, the patient should close their eyes if near the face
- the Wood's lamp should be TGA approved for clinical use in Australia (usually Class 1)
- see at bottom for a list
- there are many simpler, much cheaper Wood's lamps online for consumer use and not for clinical use and these may be TGA exempt - but shouldn't be used clinically
Wavelength utility
- 365nm is the traditional Wood's lamp frequency
- 365nm and 385nm wavelengths are also used for evaluating superficial pigmentation and skin features, helping improve visibility of pigmented areas and vascular structures
- 405nm wavelength is used for fluorescence imaging, supporting visualisation of specific skin conditions under controlled lighting conditions
- a 495nm long pass filter is often used to increase contrast and emphasize flourescence
Examples
| Appearance | normal skin variations |
|---|---|
| blue white | normal skin |
| bright flourescent | hydrated skin |
| purple flourescent | thin dehydrated skin |
| light violet | dehydrated skin |
| white spots | horny layer of skin or skin dead cells |
| white flourescent | thick corneum layer of skin |
| brown | pigmentation / dark spots |
| bright yellow flourescent | oily skin / comedone / milia |
| Appearance | skin pathology |
|---|---|
| coral red flourescence | erythrasma (Corynebacterium) bacterial porphyrins esp. in skin folds, arm pit, groin |
| yellow-green / coppery orange flourescence | tinea versicolor (Malassezia) due to pityrialactone |
| green flourescence | Monocytogenes |
| light blue-green flourescence | tinea capitis due to Microsporum audouinii, M. canis, etc - due to the metabolite pteridine |
| dull blue flourescence | tinea capitis due to Trichophyton schoenleinii |
| bright green flourescence | tinea - Microsporum ferrugoid, M. woolly, M. gypseum; Pseudomonas (due to pyocyanin pigment); |
| dark green flourescence | tinea versicolor; Pseudomonas; |
| bright or strong red flourescence | pigmentation, melasma, coffee spots, erthropoietic protoporphyria |
| bright blue white flourescence | vitiligo, albinism due to total melanin loss and dermal collage auto-flouresceses |
| Appearance | urine pathology |
|---|---|
| bright pink-orange flourescence | porphyria tarda |
| red flourescence | congenital porphyria |
Professional TGA approved devices with Wood's lamp functionality
-
- 75mm 2x lens basic digital version of a Wood's lamp; AA batteries;
- ~$AU1000
-
- 100mm 2x lens for skin examination
- Five lighting modes: polarized white, 365nm, 385nm, 405nm and Wood lamp mode (a custom blend of frequencies)
- OptiClip 495nm Long-Pass – supports fluorescence imaging contrast
- OptiClip 2.5x – increases magnification for detailed skin examination
- USB-C rechargeable lithium-ion rechargeable battery
- ~$AU1400
-
- 32mm 10x dermatoscope with 365nm UV as well
- 4 PigmentBoost® LEDs
- ~$AU2722
-
- 32mm 10x dermatoscope with 365nm UV as well
- 9 adjustable colour temperature levels
- ~$AU2915
woodslamp.txt · Last modified: 2026/08/12 09:35 by gary1